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Tehilla Steiner, Sylvia R Kodsi, Anne Steiner; Cornea Subepithelial Opacities in Pediatric Patients Using Opti-Free ® Contact Lens Solution. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3230.
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Multipurpose contact lens solutions, such as Opti-free ®, are commonly used to disinfect contact lenses. There are no current published reports of subepithelial opacities in children or adult contact lens patients who use Opti-Free ® contact lens solution.
A retrospective chart review was conducted for all pediatric patients seen in 2013 by one pediatric ophthalmologist with subepithelial opacities associated with contact lens wear and the use of Opti-Free ® contact lens solution.
Five patients were identified. Four were seen for their annual examinations with vague symptoms of ocular irritation. One patient presented as an emergency visit with intense pain. All patients were found to have multiple, less than 1mm, subepithelial opacities which did not stain with fluorescein. Three of the five patients had bilateral lesions. All patients had best correct visual acuity of 20/20 in both eyes. The subepithelial opacities resolved over a period of 2 weeks to 2 months in all patients with the discontinuation of contact lens wear, except in one case. The patients resumed contact lens wear with hydrogen peroxide contact lens solution without recurrence of the corneal opacities.
All multipurpose contact lens solutions can cause some degree of corneal toxicity, however this usually presents as an epithelial toxicity. The appearance of subepithelial opacities related to Opti-Free ® contact lens solution seems to be a unique form of toxicity related to this particular solution. Opti-Free ® contact lens solution was associated with ocular irritation and subepithelial opacities in our case series.
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